Dealing with General Anxiety Disorder (and Worry that Gets in the Way of Life)

Transcription

1 Dealing with General Anxiety Disorder (and Worry that Gets in the Way of Life) What s inside: Page: What is GAD and what does it look like? 2 Do I have GAD? A checklist for seeking help 4 How is GAD treated? 5 Some self-help skills for treating GAD 7 What is GAD and what does it look like? Lifespan Development Group Inc. Psycho-Educational Materials Page 1

2 Everybody feels anxiety from time to time. In fact, feeling anxious is not always a bad thing as it pushes us to perform well and stay motivated. Generalized anxiety disorder (GAD) however is a common anxiety disorder that involves chronic worrying, nervousness, and tension. Unlike a phobia, where your fear is connected to a specific thing or situation, the anxiety of generalized anxiety disorder is diffuse a general feeling of dread or unease that colors your whole life. This anxiety is less intense than a panic attack, but much longer lasting, making normal life difficult and relaxation impossible. If you have GAD you may worry about the same things that other people do, but you take these worries to a new level. Below is a table that highlights the differences between normal worry and GAD: Normal Worry vs. Generalized Anxiety Disorder (GAD) Normal Worry GAD Your worrying doesn t get in the way of Your worrying significantly disrupts your your daily activities and responsibilities job, activities or social life. You re able to control your worrying. Your worrying is uncontrollable. Your worries, while unpleasant, don t Your worries are extremely upsetting and cause significant distress. stressful. Your worries are limited to a specific, You worry about all sorts of things, and small number of realistic concerns. tend to expect the worst. Your bouts of worrying last for only a You ve been worrying almost every day short period. for at least six months. Symptoms of GAD may be emotional, behavioural or physical. Below is a list of the most common symptoms: Emotional symptoms of generalized anxiety disorder Constant worries running through your head Feeling like your anxiety is uncontrollable; there is nothing you can do to stop the worrying Intrusive thoughts about things that make you anxious; you try to avoid thinking about them, but you can t An inability to tolerate uncertainty; you need to know what s going to happen in the future Lifespan Development Group Inc. Psycho-Educational Materials Page 2

3 A pervasive feeling of apprehension or dread Behavioral symptoms of generalized anxiety disorder Inability to relax, enjoy quiet time, or be by yourself Difficulty concentrating or focusing on things Putting things off because you feel overwhelmed Avoiding situations that make you anxious Physical symptoms of generalized anxiety disorder Feeling tense; having muscle tightness or body aches Having trouble falling asleep or staying asleep because your mind won t quit Feeling edgy, restless, or jumpy Stomach problems, nausea, diarrhea People develop GAD for a number of reasons. In terms of evolution, we are all programmed to feel anxious in order to keep us safe. Research has shown that significant life events such as being bullied at work, may cause an individual to develop GAD. In addition to this there is evidence to suggest that GAD may develop due to an individual s thinking styles or their biological make-up. It is likely a combination of all of these factors that influences an individual s anxiety levels. As just mentioned, an individual s thinking styles may contribute to their development of GAD. Similarly, an individual who is generally worrisome or anxious may be so due their unhelpful thinking patterns. An example of these thinking styles is someone who consistently presumes that the worst is going to happen, or someone who constantly expects danger. These types of thought processes may impact on how that individual behaves. For instance, that individual might become avoidant in order to manage their anxiety. This in turn can have negative ramifications for that individual s day-to-day life and their overall well-being. Overall an anxious individual s Lifespan Development Group Inc. Psycho-Educational Materials Page 3

4 thoughts, behaviours, feelings and physical symptoms may feed into one another to maintain the anxiety. This is demonstrated in Figure 1. Figure 1 Do I have GAD? a checklist for seeking help The following is a list of common symptoms of GAD. If you tick a number of these items, you may be experiencing symptoms of anxiety or GAD and it may be beneficial for you seek further guidance. The information in this booklet will be beneficial to you. Lifespan Development Group Inc. Psycho-Educational Materials Page 4

5 Please tick the boxes which regularly apply to you. Feelings On edge ( ) Nervous ( ) Panicky ( ) Stressed ( ) Irritable/low patience threshold ( ) Uptight ( ) Physical Symptoms Tense body/muscular pain ( ) Dizzy/Faint ( ) Chest tight or painful ( ) Stomach Churning ( ) Trembling or tingling sensations ( ) Heart racing/palpitations ( ) Breathing faster or slower than usual ( ) Concentration difficulties ( ) Thinking styles You often worry 'what if' something bad happens ( ) Your mind jumps from worry to worry ( ) You often imagine the worst case scenarios ( ) You are always on the look out for danger ( ) Behaviour Patterns Avoid doing things you would like to ( ) Pace around/find it hard to relax ( ) Snap at people too easily ( ) Get easily flustered ( ) Talk very quickly ( ) Lifespan Development Group Inc. Psycho-Educational Materials Page 5

6 How is GAD treated? There are a number of options for the treatment of GAD. Research has shown that both psychotherapeutic and medication-based solutions have been effective. It is advisable that you make yourself as informed as possible on what your options are. There are a number of simple things that you can do yourself to help reduce your GAD symptoms: Lifestyle Changes. There are a number of simple lifestyle changes that you should try to make if you are feeling anxious. These include: o Exercise. Exercise reduces tension and stress and boosts the release of endorphins, the brain s feel-good chemicals. Try to complete some physical exercise every day to reduce your feelings of anxiety. o Sleep. Issues with sleep are common for people with GAD. Improve your sleep by avoiding daytime napping, caffeine products, browsing mobile devices and excitable television late at night. Try to get between 7-9 hours of sleep per night. o Nutrition. Eating well is important for both your physical and mental health. It you experience physical symptoms of anxiety, it is important to keep your blood sugar levels relatively stable, avoid sugary snacks and eat balanced meals regularly. Avoid caffeine and alcohol. o Social Support. Support from other people is vital when overcoming GAD. Social interaction with someone who cares about you will help to calm your nervous system and diffuse your anxiety. Be aware also that anxiety and constant worrying about your relationships may leave you feeling needy and insecure. Try to be aware of the effect that your anxiety is Lifespan Development Group Inc. Psycho-Educational Materials Page 6

7 having on those around you surround yourself with supportive people. Medication Medication has been shown to be effective for some people in the treatment of GAD. There are typically three types of medication prescribed for GAD: Buspirone, Benzodiazepines and Antidepressants. Medication is often only prescribed as a temporary measure to relieve symptoms of anxiety at the beginning of the treatment process. It is important to remember however that medication does not get to the root of the problem and instead just treats the symptoms. Some people experience some side-effects when taking medication. If you have any questions or concerns regarding anti-depressant medication, you should seek advice from your doctor or a medical professional. Psychotherapy There are a number of psychological therapies that have been shown to be effective for the treatment of depression. These include but are not limited to: o Cognitive Behavior Therapy (CBT). CBT focuses on identifying, understanding, and changing thinking and behavior patterns. In this type of therapy the patient is actively involved in his or her own recovery, has a sense of control, and learns skills that are useful throughout life. o Dialectical Behavioral Therapy (DBT). Integrating cognitivebehavioral techniques with concepts from Eastern meditation, dialectical behavioral therapy, or DBT, combines acceptance and change. DBT involves individual and group therapy to learn mindfulness, as well as skills for interpersonal effectiveness, tolerating distress, regulating emotions. Lifespan Development Group Inc. Psycho-Educational Materials Page 7

8 o Acceptance-Commitment Therapy (ACT). The core message of ACT is to accept what is out of your personal control and commit to action that improves and enriches an individual s life. This is done through the teaching of mindfulness skills to deal with painful thoughts and feelings effectively and by helping an individual identify their values to motivate change. o Interpersonal Therapy (IPT). The underlying assumption with interpersonal therapy is that anxiety and interpersonal problems are interrelated. The goal of interpersonal therapy is to help a person understand how these factors are operating in their current life situation to lead them to become anxious or depressed and put them at risk for future depression. Some self-help skills for GAD Challenging Negative Automatic Thoughts (NATs) As mentioned earlier, the way that we think about things can impact on our anxiety levels. Our thoughts can feed into our behaviours, our feelings and how we feel physically, and so it is important to remember that they are just thoughts, and not fact. If thoughts are not facts, then they can be challenged. Negative Automatic Thoughts (NATs) are common in GAD and recognizing them is the first step in learning to change them. By becoming aware of these thoughts and the effect that they are having on us, we are working towards breaking the cycle of anxiety. Below are some common NATs: o Predicting the Future: When we are feeling anxious, it is common for us to spend a lot of time thinking about the future and predicting what could go wrong, rather than just letting things be. In the end most of our predictions don't happen and we have wasted time and energy being worried and upset about them. e.g. Assuming you will perform poorly at your job interview. o Mind Reading: This means that you make assumptions about others' beliefs without having any real evidence to support them. e.g. My boss thinks I'm stupid. Lifespan Development Group Inc. Psycho-Educational Materials Page 8

9 o Catastrophising: People commonly 'catastrophise' when they are anxious, which basically means that they often blow things out of proportion. e.g. They assume that something that has happened is far worse than it really is (e.g. that their friend is going to dislike them because they cancelled a night out). o Focusing on the Negatives: Anxious people often have a tendency to focus on the negatives which keeps their anxiety going. e.g. They focus on the one person at work who doesn't like them, ignoring that they are very popular with the rest of their colleagues. o Should Statements: People often imagine how they would like things to be or how they 'should be' rather than accepting how things really are. Unfortunately when we do this, we are simply applying extra pressure to ourselves that can result in anxiety. Instead it can sometimes help to accept that things can't always be perfect. e.g. I should never be anxious. o Over Generalising: Based on one isolated incident you assume that all others will follow a similar pattern in the future. For e.g. When enrolling on a college course, you meet a future classmate who you find irritating. As a result, you worry that everyone in the class will be the same and you won't make any friends. o What If Statements: Have you ever wondered "what if" something bad happens? This type of thought can often make us avoid going places or doing the things that we would like. e.g. What if I have a panic attack at the party? o Labelling: Do you find that you attach negative labels to yourself? e.g. I'm weak. Labels like these really influence how we see ourselves and can heighten our anxiety levels. If some of these thought processes resonate with how you think about things, it might be useful to try to challenge your NATs. On the next page is a helpful template to track your challenging thoughts: Lifespan Development Group Inc. Psycho-Educational Materials Page 9

10 Where were you? Emotion or feeling Negative automatic thought Evidence that supports that thought Evidence that does not support that thought Alternative thought Emotion or feeling following alternative thought Lifespan Development Group Inc. Psycho-Educational Materials Page 10

11 Relaxation techniques. Anxiety is more than just a feeling. It s the body s physical fight or flight reaction to a perceived threat. Your heart pounds, you breathe faster, your muscles tense up, and you feel light-headed. When you re relaxed, the complete opposite happens. Since it s impossible to be anxious and relaxed at the same time, strengthening your body s relaxation response is a powerful anxiety-relieving tactic. Progressive muscle relaxation, deep breathing, and meditation can help you to relax. These are skills that might take some practice initially. The following are a set of links to further information about these relaxation techniques. Progressive muscle relaxation can help you release muscle tension and take a time out from your worries. The technique involves systematically tensing and then releasing different muscle groups in your body. As your body relaxes, your mind will follow. Deep breathing. When you re anxious, you breathe faster. This hyperventilation causes symptoms such as dizziness, breathlessness, lightheadedness, and tingly hands and feet. These physical symptoms are frightening, leading to further anxiety and panic. But by breathing deeply from the diaphragm, you can reverse these symptoms and calm yourself down. Lifespan Development Group Inc. Psycho-Educational Materials Page 11

12 Meditation. Research shows that mindfulness meditation can actually change your brain. With regular practice, meditation boosts activity on the left side of the prefrontal cortex, the area of the brain responsible for feelings of serenity and joy. Body-And-Breath-from-book-Mindfulness-Finding-Peace-in-a-Frantic-World- 128k.mp3 Self-soothing Self-soothing is a simple skill that people with GAD can use to calm and soothe themselves when they feel themselves becoming anxious. Self-soothing involves using one or more of the senses: vision, hearing, smell, taste and touch (or movement) to make oneself feel better. For example: o Vision. Go to a place that you find visually calming, look a picture of place that you have fond memories of, watch a pleasant film, go to an art museum. o Hearing. Listen to the calming music, sing a familiar song, speak with a friend, enjoy the sounds of nature. o Smell. Smell your favourite perfume, light some scented candles/incense, smell flowers in the garden, do some cooking/baking. o Taste. Eat your favourite treats and savour the taste mindfully, have a cup of tea, go for a fine meal. o Touch. Rub a pet, squeeze a stress ball, get a massage, have a shower/bath. o Movement. Go for a run/walk, dance around, do some stretches. Lifespan Development Group Inc. Psycho-Educational Materials Page 12

13 These self-soothing techniques are extremely simple and will vary depending on the individual. Some people might find it useful to develop their own Self-Soothing Box. This can be a box of some sort (e.g. an old shoe box) that you can fill with items that you find self-soothing (e.g. your favourite chocolate bar, your favourite photos, a cd of calming music, some scented oils) and turn to when you feel your GAD symptoms increasing. Some useful links for further reading: Booklet on generalized anxiety disorder, including its symptoms and treatment. (National Institute for Mental Health) Series of self-help modules for generalized anxiety disorder. Includes stepby-step tips for dealing with anxiety and worry. (Centre for Clinical Interventions) Lifespan Development Group Inc. Psycho-Educational Materials Page 13